Individual provider Active NPI

Martina Tetrick, LMHC

  • Mental Health Counselor
  • Orlando, FL
National Provider Identifier
1376732594
Registry record updated Mar 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH7529 Issued in FL
Practice address
2020 E Robinson St
Orlando, FL 32803-6045
Phone
(407) 929-6821
Fax
(407) 898-2805
NPI assigned
Oct 24, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH7529 FL Primary

Addresses

Primary practice location

2020 E Robinson St
Orlando, FL 32803-6045

Mailing address

1223 Lake Highland Dr
Orlando, FL 32803-2601
Phone (407) 929-6821

Other identifiers 1

IdentifierTypeStateIssuer
768765600MedicaidFL

Other names 1

  • Martina Gallagher Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 10, 2025 through Feb 10, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MH7529FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Tetrick Counseling, LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301529600000",
    "number": "1376732594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1223 LAKE HIGHLAND DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328032601",
            "telephone_number": "407-929-6821",
            "fax_number": "407-898-2805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 E ROBINSON ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328036045",
            "telephone_number": "407-929-6821",
            "fax_number": "407-898-2805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TETRICK",
        "first_name": "MARTINA",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-24",
        "last_updated": "2011-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH7529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "768765600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARTINA",
            "last_name": "GALLAGHER",
            "credential": "LMHC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.